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neuromuscular II > lecture 1 intro to spinal cord > Flashcards

lecture 1 intro to spinal cord Flashcards

1
Q

What is SCI

A

damage to the spinal cord resulting in symptoms below the level of injury

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2
Q

DCML _______ location, ________ touch
–sensory or motor:
–cross:
–function:
–ascending or descending:

A

precise, discriminative
sensory
medulla
two-point discrimination, proprioception, vibration
ascending

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3
Q

Spinal Thalamic Tract
–sensory or motor
–cross:
–function:
–ascending or descending:

A

sensory
spinal cord
non-discriminative/crude touch, pain, temperature, itch, tickle, sexual sensations
ascending

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4
Q

Corticospinal Tract -
sensory or motor
cross:
function:
ascending or descending:

A

motor
pyramids
voluntary distal movements
descending

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5
Q

Most common between ages _____ and ____+

A

15-29 and 65+

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6
Q

Leading cause of traumatic mechanism of injury for SC:

A

MVA (38%)

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7
Q

Incomplete injuries generally have a ___________ life expectancy than complete injuries.
____________ (Tetraplegia/Paraplegia) tends to have a shorter life expectancy compared to ____________ (Tetraplegia/Paraplegia).

A

longer; tetraplegia; paraplegia

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8
Q

Cost of Care for SCI is inexpensive. T or F?

A

False; expensive

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9
Q

Spinal shock happens when?
A period of areflexia lasts ____ hrs.
Reflexes return gradually over ______ days. Can have hyperreflexia for ______ weeks after

A

immediately after SCI
24hrs.
1-3 days
1-4 weeks

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10
Q

SCI are named by (3)

A

spinal level of injury
anatomical location of injury in cord
completeness of injury

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11
Q

Lower cervical tetraplegia life expectancy is longer than higher cervical tetraplegia due to

A

phrenic nerve, diaphragm

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12
Q

The ______ was created by the International Standard for Neurological Classification of SCI injury to determine _______ _______.

A

ASIA; SCI level

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13
Q

The ASIA looks at motor and sensory levels bilaterally as well as sacral tone and sensation to determine: (5)

A

motor level of injury
sensory level of injury
neurologic level of injury (NLI)
complete or incomplete
zone of partial perservation (ZPP)

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14
Q

Above T12 indicate ______ injury and below T12 indicates ______ injury

A

UMN; LMN

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15
Q

No motor or sensory function was preserved in the sacral segments S4 to S5

A

A = complete

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16
Q

Sensory but no motor function is preserved below the neurological level and includes the sacral segments S4 to S5

A

B = incomplete

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17
Q

Motor function is preserved below the neurological level and more than half of key muscles below the neurological level have a muscle grade of less than 3

A

C = incomplete

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18
Q

Motor function is preserved below the neurological level and at least half of the key muscles below the neurological level have a grade of 3 or more

A

D = incomplete

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19
Q

Motor and sensory functions are normal

A

E = normal

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20
Q

motor level of injury,” doctors look for the lowest muscle group where the strength is at least ______, as long as the muscle group just above it has a strength of ______.

A

3; 5

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21
Q

sensory level of injury, clinicians note the pts. most _____ level with a normal light touch and pinprick sensation on both L and R to determine the level

A

caudal

22
Q

dermatomes and myotomes caudal to the sensory or motor level that remain partially innervated are known as

A

zone of partial preservation (ZPP)

23
Q

Both voluntary anal contraction (VAC) and deep anal pressure (DAP) need to be absent for a ________ spinal cord injury

A

complete

24
Q

Anterior Cord Syndrome -

A

B loss of CST and STT
hyperflexion injury

25
Q

Central Cord Syndrome -

A

UE’s more affected than LE’s, with varying º of sensory impairment, sacral sparing
stenosis

26
Q

Brown Sequard Syndrome -

A

Ipsilateral loss of DCML and CST, contralat. loss of STT

27
Q

Posterior cord Syndrome -

A

B loss of DCML
hyperextension injury
motor intact

28
Q

Conus Medullaris Syndrome -

A

Mixed LMN and UMN

29
Q

Cauda Equina Syndrome -

A

LMN, flaccid paresis, saddle anesthesia

30
Q

UMN = ______ conus medullaris
LMN = ______ conus medullaris

A

above
below

31
Q

LMN generally below ______
hypo/hyperreflexia
flaccidity/spasticity
increased/decreased tone/spasticity
-/+ UMN signs
flaccid/contracted bowel and bladder

A

T12
hyporeflexia
flaccidity
decreased tone/spasticity
-UMN signs
flaccid bowel and bladder

32
Q

UMN generally above ______
hypo/hyperreflexia
flaccidity/spasticity
increased/decreased tone/spasticity
-/+ UMN signs
flaccid/contracted bowel and bladder

A

T12
hyperreflexia
increased tone/spasticity
+ UMN signs
spastic bowel and bladder

33
Q

Which type of setting is described:
–ICU
–Floor
–1-3 weeks
–getting upright tolerance
–basic mobility

A

Acute Care

34
Q

Which type of setting is described:
–4-12 weeks
–learning ADLs
–mobility
–wheelchair training
–bracing
– best for intensity

A

acute rehab

35
Q

Which type of setting is described:
–usually patients with higher level SCI on vents
–or after flap Sx

A

LTACH

36
Q

Which type of setting is described:
–community integration
–MSK injury prevention
–sports

A

outpatient

37
Q

Secondary Complications of the Cardiovascular/Pulmonary:
– what level does this occur?

A

–PNA
–Aspiration
–diaphragmatic/respiratory muscle impairment
–PE/DVT
–BP management

– C4 and above

38
Q

Secondary of Autonomic Dysreflexia

A

HTN (raise of 20-30 mmHg systolic)
Bradycardia
flushing due to vasodilation
Headache
Profuse sweating
Blurred vision
Dry pale skin due to vasoconstriction

39
Q

Secondary Complications: MSK

A

motor loss
osteoporosis
overuse injuries
heterotopic ossification
osteomyelitis

40
Q

Psychological Complications: psychological

A

adjustment to trauma and/or loss
higher depression rates

41
Q

Secondary complication: GI/GU

A

UTI
reflexive bladder/bowel
flaccid bladder/bowel

42
Q

Secondary complications: Integ

A

high risk for pressure injuries due to:
- decreased sensation
- decreased mobility
- decreased blood flow

43
Q

Stages of Integ complications:
stage 1
stage 2
stage 3
stage 4

___________ persistent non-blancable discoloration with a dark wound bed due to prolonged pressure or shear. May evolve rapidly to stage 3 or 4

A

intact skin, non blanchable
partial thickness looks like blister or scrape
full-thickness, into subcu fat layer
full-thickness involving muscle or bone
deep tissue pressure injury

44
Q
A

stage 1

45
Q
A

deep tissue pressure

46
Q
A

stage 4

47
Q
A

stage 3

48
Q

PT management: Acute Care

A

early mobility once medically stable
focus exam on sensory/motor function, respiratory function, skin integrity, PROM, BP fluctuations

interventions:
PROM/contracture prevention
skin prevention
BP management with change in pos.
edu./ basic mobility

49
Q

within ______ hours, perform ASIA

A

72 hours

50
Q

PT management: Acute Rehab

A

ROM, strength, outcome measures, functional mobility level

intervention:
aerobic capacity
skin management
ADLs/functional mobility
pain/spasticity management
education
sterngthenign
DME, w/c, bracing

51
Q

PT management: LTACH

A

mobility as able
exam focus = same for acute care

interventions:
skin prevention or treatment *** usually here due to flap Sx
respiratory function

52
Q

PT management: Out-patient

A

PT exam MSK/Neuro/Pulm/Integ integrity
knowledge of SCI and level of independence

interventions:
community reintegration/navigation
goal-directed activities: return to sport, childcare, work etc.
prevent MSK repetitive use injuries
overall strengthening

neuromuscular II (18 decks)

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